Healthcare Provider Details

I. General information

NPI: 1164700076
Provider Name (Legal Business Name): SOUND SOLUTIONS HEARING CENTERS OF MINNESOTA LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 W DIVISION ST STE 4
SAINT CLOUD MN
56301-3729
US

IV. Provider business mailing address

4101 W DIVISION ST STE 4
SAINT CLOUD MN
56301-3729
US

V. Phone/Fax

Practice location:
  • Phone: 320-259-5841
  • Fax: 320-259-5845
Mailing address:
  • Phone: 320-259-5841
  • Fax: 320-259-5845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number2642
License Number StateMN

VIII. Authorized Official

Name: TODD LAU
Title or Position: OWNER
Credential:
Phone: 320-259-5841